Infrastructure improvements enhance HIV services at Salima District Hospital and Area 25 Health Centre

​Prior to the construction of the Mwai Anti-Retroviral Treatment (ART) Clinic at Salima District Hospital, patients awaiting an ART clinic visit were squeezed into the main corridor of the tuberculosis (TB) ward. Lucky clients might have found a seat by crowding onto one of several benches lining the “waiting area,” also serving as the hallway to the TB office.  Many sat on the floor.  Upon entering the clinician’s room, the patient found no improvement.  With two clinics squeezed into one tiny space (TB provider and TB client on one side of the room with ART on the other), patients found themselves without fearful of disclosure and facing possible TB exposure on every visit to the clinic. Similarly, clients seeking TB services found their visits interrupted by frequent entry and exit of clients receiving ART refills. Those requiring HIV Testing and Counseling and Dried Blood Spot services were forced to walk nearly 200 meters to access services provided from a separate building. 

​ At Area 25 Health Center, the lacking infrastructure presented a similar challenge.  An overflow of clients waiting outside for HIV services in the sun or rain in a long queue was a common occurrence. Community health workers offered counselling and testing services from a 20 foot container located far from the related family planning, STI, and antenatal clinics causing confusion and many patients failing to test.  The space was simply inadequate to offer quality services to patients.       

The construction of Mwai and Thandizo ART clinics in Salima and Area 25 presented refreshing solutions to the infrastructure challenges at these sites. Access to a pleasant, spacious, and sanitary space in which a client can obtain HIV services not only improves the client experience, but is also motivating to health workers.  With more room to provide ART services, several clients can be served at once in different consultation rooms where they are able to access ART, treatment of opportunistic infections, HTC/DBS, TB screening, malaria testing, and patient education.  HIV Care Clinic services—including a separate place for triage—are now all under one roof.  Clients, including couples, are assured of privacy and confidentiality as they sit in an enclosed and spacious waiting area with adequate benches. 

Plaque and new ART clinic with CHW bicycles at Salima District Hospital.

A lasting gift to clients and health care providers, the new clinics at Salima DH and Area 25 HC have improved the quality of care and treatment to HIV infected and affected clients as well as the hard-working health providers caring for them.